Dermatological cryospray devices having linear array of nozzles and methods of use

ABSTRACT

The present invention is directed to improved systems, devices, and methods for delivery of a cryogen to the skin of a patient for skin treatment. A cryospray device configured to deliver a cryogen to a patient&#39;s skin can include an applicator, a supply channel, and a nozzle assembly. The applicator can include a head portion, and the supply channel can extend through at least a portion of the head portion. The nozzle assembly can be coupled to the head portion and can be fluidly coupled to the supply channel. The nozzle assembly can include a linear array of orifices that are configured to direct a planar spray of the cryogen to cool an area of a skin tissue of the patient in a linear cooling treatment.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 16/020,852, filed Jun. 26, 2018, and titled “DERMATOLOGICALCRYOSPRAY DEVICES HAVING LINEAR ARRAY OF NOZZLES AND METHODS OF USE,”which claims priority from U.S. Patent Application No. 62/527,652, filedJun. 30, 2017, and titled, “DERMATOLOGICAL CRYOSPRAY DEVICES HAVINGLINEAR ARRAY OF NOZZLES AND METHODS OF USE,” the entirety of each ofwhich are hereby incorporated by reference herein.

BACKGROUND

Cryotherapy is the local or general use of cold in medical therapy.Cryotherapy can include the controlled freezing of biological tissue,which controlled freezing of biological tissue, such as skin tissue, canproduce various effects. Certain tissue freezing procedures and devices,such as conventional cryoprobes, can cause severe freezing of tissue andgenerate cellular and visible skin damage.

There is a demand for dermatologic products that can lighten theappearance of skin or otherwise controllably affect skin pigmentation.For example, it may be desirable to lighten the overall complexion orcolor of a region of skin to alter the general appearance for cosmeticreasons. Also, lightening of particular hyperpigmented regions of skin,such as freckles, ‘café au lait’ spots, melasma, or dark circles underthe eyes that may result from excessive local amounts of pigment in theskin, may also be desirable for cosmetic reasons. Hyperpigmentation canresult from a variety of factors such as UV exposure, aging, stress,trauma, inflammation, etc. Such factors can lead to an excess productionof melanin, or melanogenesis, in the skin by melanocytes, which can leadto formation of hyperpigmented areas. Such hyperpigmented areas may beassociated with excess melanin within the epidermis and/ordermal-epidermis junction. However, hyperpigmentation can also resultfrom excess melanin deposited within the dermis.

Hypopigmentation of skin tissue has been observed as a side effect inresponse to temporary cooling or freezing of the tissue, such as mayoccur during conventional cryosurgery procedures. Loss of pigmentationfollowing skin cooling or freezing may result from decreased melaninproduction, decreased melanosome production, destruction of melanocytes,or inhibited transfer or regulation of melanosome into the keratinocytesin the lower region of the epidermal layer. The resultanthypopigmentation may be long-lasting or permanent. However, it has alsobeen observed that some of these freezing procedures can generateregions of hyperpigmentation (or skin darkening) of skin tissue. Thelevel of increase or decrease in pigmentation may be dependent uponcertain aspects of the cooling or freezing conditions, including thetemperature of the cooling treatment, and the length of time the tissueis maintained in a frozen state.

Improved hypopigmentation treatments, devices, and systems have beendeveloped to improve the consistency of skin freezing and the overallhypopigmentation consistency. For example, it has been observed thatmoderate degrees of freezing (e.g., −4 to −30 degrees Celsius) atshorter time frames (e.g., 30 to 60 seconds) can produce particulardermatological effects, such as affecting the expression of skinpigmentation (e.g., hypopigmentation). Cryotherapy can be provided usinga variety of techniques including the direct application of a cryogenspray to the skin of the patient or the application of a cooled probe orplate to the skin of the patient. Exemplary methods and devices aredescribed in: U.S. Patent Publication No. 2011/0313411, filed on Aug. 7,2009, and entitled “METHOD AND APPARATUS FOR DERMATOLOGICALHYPOPIGMENTATION”; U.S. Patent Publication No. 2014/0303696, filed onNov. 16, 2012, and entitled “METHOD AND APPARATUS FOR CRYOGENICTREATMENT OF SKIN TISSUE”; U.S. Patent Publication No. 2014/0303697,filed on Nov. 16, 2012, and entitled “METHOD AND APPARATUS FOR CRYOGENICTREATMENT OF SKIN TISSUE”; U.S. Patent Publication No. 2015/0223975,filed on Feb. 12, 2015, and entitled “METHOD AND APPARATUS FOR AFFECTINGPIGMENTATION OF TISSUE”; U.S. Patent Publication No. 2017/0065323, filedon Sep. 6, 2016, and entitled “MEDICAL SYSTEMS, METHODS, AND DEVICES FORHYPOPIGMENTATION COOLING TREATMENTS”, the entirety of each of which ishereby incorporated by reference herein.

While the treatment of skin or a localized lesion to affect pigmentationcan be accomplished with cryotherapy, it may be desirable to provideimproved methods, systems, and devices for cryotherapy. In particular,improved designs, controls and parameters associated with cryogendelivery to achieve consistent and reliable skin freezing and desiredskin treatment effect may be of benefit. Accordingly, improveddermatological cryospray methods, systems, and devices are desirable.

BRIEF SUMMARY

The present invention relates to improved systems, devices, and methodsof delivery of a cryogen to the skin of a patient for skin treatment.More specifically, the present invention relates to improveddermatological cryospray methods, devices, and systems that provideconsistency of skin treatment by reliably freezing the skin duringtreatment while limiting adverse side effects from the skin freezing.Exemplary embodiments include a nozzle design comprising a linear arrayof orifices. This linear array of orifices can deliver a linear spray ofcryogen or cold gas to the skin surface when cryogen or cold gas isdispensed through those orifices. Advantageously, this linear sprayapplication provides a line of cooling treatment that facilitatesuniform and even treatment of large areas of skin. The linear coolingtreatment facilitates a sweeping delivery of cryogen or cold gas to apatient's skin by uniformly delivering cryogen or cold gas through thelinear array of orifices. Uniformly and consistently treating largeareas of skin may be of particular benefit for a variety of skinindications, such as pigmentation or coloration related indicationsincluding hypopigmentation or hyperpigmentation; acne; rosacea;psoriasis melasma; lentigines; freckle; birthmark, liver spot, age spot,or café au lait macule.

One aspect of the present disclosure relates to a method of cooling anarea of skin of a patient. This method includes: positioning a cryosprayapplicator to a position proximate to the area of the skin tissue of thepatient to be treated; and directing a planar spray of cyrogen through alinear array of orifices of the cryospray applicator to cool the area ofthe skin tissue of the patient in a line of cooling treatment to effecta treatment of the skin.

In some embodiments, this method includes heating a tank containingliquid and gaseous cryogen with a tank heater such that the tankmaintains a desired pressure. In some embodiments, the cryogen caninclude: a liquid cryogen; a gaseous cryogen; a two-phase fluid; cooledair; and/or carbon dioxide. In some embodiments, directing the planarspray of cryogen or cold gas through the linear array of orificesincludes transporting cryogen such as liquid cryogen from the tank to anapplicator via a supply tube. In some embodiments, a pressure of theliquid cryogen in the supply tube is substantially equal to the desiredpressure in the tank. In some embodiments, the method includes movingthe cryospray applicator so as to provide a linear curtain of coolingtreatment to the area of the skin tissue of the patient. In someembodiments, directing the planar spray of liquid cryogen or cold gasthrough the linear array of orifices includes locally freezing anepidermis to alter a pigmentation of the area of the skin tissue of thepatient.

In some embodiments, directing the planar spray of cryogen, which caninclude liquid cryogen, cold gas, or two-phase fluid including liquidcryogen and gas, through the linear array of orifices includes locallydisrupting an epidermis to produce gradual skin lightening in the areaof the skin tissue of the patient. In some embodiments, the planar sprayof cryogen can comprise one or several liquid cryogen droplets, and insome embodiments, the liquid cryogen can be liquid carbon dioxide. Insome embodiments, the planar spray of liquid cryogen has a temperatureat the skin surface of between −4 C to −80 C.

In some embodiments, each orifice can be and/or include a cylindricalopening. In some embodiments, the linear array of orifices can be asingle row of orifices or a plurality of rows of orifices. In someembodiments, the method includes delivering a gas to form a protectivecurtain through which the liquid cryogen or cold gas moves downstream ofthe orifices. In some embodiments, the protective curtain prevents waterentrainment or ambient air entrainment as the liquid cryogen or cold gasmoves downstream of the orifices. In some embodiments, the gas isexpelled from the orifices before or during the directing the planarspray of liquid cryogen or cold gas from the orifices. In someembodiments, the gas includes at least one of: a dry gas; or an inertgas.

In some embodiments, positioning the cryospray applicator to theposition proximate to the area of the skin tissue of the patientincludes contacting the area of skin tissue of the patient with amechanical spacer to maintain a predetermined distance between thecryospray applicator and the skin tissue. In some embodiments, thepredetermined distance includes a range from 0.125 inches to 3 inches.In some embodiments, the mechanical spacer includes at least one of: awheeled spacer; and a sliding spacer. In some embodiments, positioningthe cryospray applicator to the position proximate to the area of theskin tissue of the patient to be treated includes positioning anon-contact cryospray applicator proximate to the area of the skintissue of the patient.

In some embodiments, the method includes applying a mask to the area ofthe skin tissue of the patient prior to directing the planar spray ofliquid cryogen or cold gas from the linear array of orifices. In someembodiments, the mask can be a perforated film. In some embodiments, themethod includes warming the area of skin tissue of the patient after thecooling treatment. In some embodiments, the area of skin tissue of thepatient is warmed by delivery of warm gas or liquid from the same ordifferent orifices for convective warming.

One aspect of the present disclosure relates to a skin cooling treatmentsystem. The system includes: a cryogen source; a non-contact cryosprayapplicator fluidly coupled to the cryogen source, which cryosprayapplicator can direct a planar spray of liquid cryogen to an area ofskin tissue of a patient to be treated, which non-contact cryosprayapplicator includes a linear array of orifices that can spray the liquidcryogen or cold gas to cool the area of the skin tissue of the patientin a line of cooling treatment.

In some embodiments, the treatment system includes a supply tube fluidlycoupling to a bottom portion of the cryogen source. In some embodiments,the cryogen source further includes a heater to maintain the cryogensource at a desired pressure or temperature range. In some embodiments,the desired temperature range can include a temperature above an ambienttemperature. In some embodiments, the cryogen source includes a liquidand gaseous cryogen. In some embodiments, the linear array of orificesincludes a single row of orifices or a plurality of rows of orifices. Insome embodiments, the orifices in the linear array of orifices have thesame dimensions, or have different dimensions. In some embodiments, theorifices are uniformly spaced or at least some of the orifices arestaggered. In some embodiments, each orifice includes a cylindricalopening.

In some embodiments, the non-contact cryospray applicator furtherincludes a nozzle tube and a shroud extending at least partially aroundthe linear array of orifices of the nozzle tube. In some embodiments,the shroud creates a stagnation zone at distal openings of the orifices.In some embodiments, the nozzle tube can be made from a first materialand the shroud can be made from a second material. In some embodiments,the second material of the shroud has a lower thermal conductivity thanthe first material of the nozzle tube. In some embodiments, the shroudhas a depth equal to at least two times a diameter of one of theorifices of the linear array of orifices. In some embodiments, thetreatment system includes a temperature control mask or a perforatedfilm. The temperature control mask or perforated skin can contact thearea of the skin tissue of the patient.

One aspect of the present disclosure relates to a cryospray device fordelivering a cryogen to a patient's skin for altering a pigmentationappearance. The cryo—spray device includes: an applicator including ahead portion; a supply channel extending at least partially through thehead portion; and a nozzle assembly coupled to the head portion andfluidly coupled to the supply channel, the nozzle assembly including alinear array of orifices that can spray the cryogen to cool an area of askin tissue of the patient in a linear cooling treatment to alter apigmentation appearance thereof.

In some embodiments, the linear array of orifices includes a single rowof orifices or a plurality of rows of orifices. In some embodiments,each orifice includes a cylindrical opening. In some embodiments, thenozzle assembly includes a nozzle tube and a shroud extending at leastpartially around the linear array of orifices. In some embodiments, theshroud creates a stagnation zone at distal openings of the orifices. Insome embodiments, the nozzle tube can be made from a first material andthe shroud can be made from a second material. In some embodiments, thesecond material of the shroud has a lower thermal conductivity than thefirst material of the nozzle tube. In some embodiments, the shroud has adepth equal to at least two times a diameter of one of the orifices ofthe linear array of orifices.

In some embodiments, the cryospray device includes a filter locatedwithin the head portion and upstream of the linear array of orifices. Insome embodiments, the filter includes a sintered metal filter. In someembodiments, the cryospray device includes an array of curtain aperturesin the nozzle assembly. In some embodiments, the array of curtainapertures can be configured to deliver a protective gas to prevent waterentrainment or ambient air entrainment as the liquid cryogen or cold gasmoves downstream of the orifices.

In some embodiments, the cryospray device includes a mechanical spacercoupled to the head portion. In some embodiments, the mechanical spacercan maintain at least a minimum or constant distance between the lineararray of orifices and a surface of the patient's skin. In someembodiments, the mechanical spacer is adjustable to change the minimumdistance. In some embodiments, the mechanical spacer includes a wheeledspacer. In some embodiments, the wheeled spacer includes a first wheellocated proximate to a first end of the linear array of orifices and asecond wheel located proximate to a second end of the linear array oforifices. In some embodiments, the mechanical spacer includes a sliderspacer, and in some embodiments, the slider spacer includes a pluralityof adjustable legs or prongs. In some embodiments, the applicatorfurther includes a handle portion sized and shaped to be held by anoperator of the cryospray device.

Embodiments of the invention covered by this patent are defined by theclaims below, not this summary. This summary is a high-level overview ofvarious aspects of the invention and introduces some of the conceptsthat are further described in the Detailed Description section below.This summary is not intended to identify key or essential features ofthe claimed subject matter, nor is it intended to be used in isolationto determine the scope of the claimed subject matter. The subject mattershould be understood by reference to appropriate portions of the entirespecification of this patent, any or all drawings, and each claim.

The invention will be better understood upon reading the followingdescription and examining the figures which accompany it. These figuresare provided by way of illustration only and are in no way limiting onthe invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic illustration of one embodiment of a cryogenictreatment system.

FIG. 2 is a side-section view of one embodiment of an applicator of acryogenic treatment system.

FIG. 3 is a side-section, close-up view of aspects of a head portion ofan applicator.

FIG. 4 is a front-section, close-up view of a nozzle including anelongate member.

FIG. 5 is a bottom view of one embodiment of a nozzle and an elongatemember including a linear array of orifices.

FIG. 6 is a schematic illustration of one embodiment of a linear arrayof uniformly spaced orifices located on an elongate member of a nozzle.

FIG. 7 is a schematic illustration of one embodiment of a linear arrayof staggered orifices located on an elongate member of a nozzle.

FIG. 8 is a schematic illustration of one embodiment of the applicationof cryogen to the skin of a patient.

FIG. 9 is a perspective view of one embodiment of a wheeled spacer.

FIG. 10 is a perspective view of one embodiment of a slider spacer.

FIG. 11 is a flowchart illustrating one embodiment of a process forcooling skin of a patient by applying a cryogen spray.

DETAILED DESCRIPTION

Embodiments of the present disclosure relate to systems, methods, anddevices for providing cryotherapy skin treatments. In some embodiments,these can include a cryospray applicator utilizing a nozzle comprising alinear array of orifices to direct cryogen or cold gas toward the skinin a planar manner that produces a line of frozen tissue to effect thedesired skin treatment, such as skin lightening or hypopigmentation. Thelinear array of orifices can be arranged in a single row of orifices orin a plurality of rows of orifices. This linear array nozzle design candirect a curtain application of cryogen or cold gas such that itimpinges on the skin surface, which can facilitate uniform andcontrolled application of cooling treatment to large treatment areas ofthe skin of a patient without undesirable side effects.

The fine-tuned linear array nozzle design of the present inventionprovides advantages over conventional spray nozzle designs, whichfrequently include a single opening or a cluster of openings. Forexample, a single opening has limited treatment area and is difficult toprovide uniform cooling treatment when sprayed over an area. A clusterof openings may provide a larger treatment area, but the cluster ofopenings may undesirably increase an intensity of the cryogen or coldgas spray against the patient's skin resulting in undesirable blastingon the skin and lack of control. Conventional nozzle designs may alsoincrease the difficulty of providing reliable and consistent cryospraydosing over large areas of skin tissue. In contrast, nozzles of thepresent disclosure comprise a linear array of orifices to facilitateuniform and even delivery of cryogen or cold gas toward large areas ofthe skin in a planar manner that produces a line of skin treatment. Thislinear coverage facilitates sweeping of the nozzle over the skin, whiledelivering controlled and consistent dosing of cryogen to the skin.

The nozzle can include features and/or be controlled to preventobstruction of some or all of the orifices in the linear array oforifices and/or to prevent the entrainment of undesired amounts ofmoisture in dispensed cryogen. These features can include a shroud thatcan be part of the nozzle. The shroud can extend wholly or partiallyaround the linear array of orifices. The shroud can, in someembodiments, decrease the likelihood of ice crystals forming at theorifices and thereby block flow of cryogen through the orifices.

The nozzle can further include one or several orifices from which aprotective gas can be dispensed. In some embodiments, this protectivegas can form a protective curtain through or inside of which the cryogencan be dispensed to prevent the entrainment of ambient moisture in thecryogen and to prevent icing of the nozzle surface during or followingthe spray or cryogen. The protective gas can be dispensed from the sameorifices or applicator from which the cryogen is dispensed by deliveringthe protective gas before or after the delivery of the cryogen, or theprotective gas can be delivered from separate orifices than those fromwhich the cryogen is dispensed. The protective gas can be, in someembodiments, nitrogen, carbon dioxide, helium, hydrogen, neon, oxygen,fluorine, argon, methane, a refrigerant, and/or air. In someembodiments, the protective gas can be an inert gas.

With reference now to FIG. 1, one embodiment of a cryogenic treatmentsystem 100 is shown. The cryogenic treatment system 100 can containand/or deliver a cryogen. This cryogen can include, in some embodiments,a liquefied gas such as liquid helium, liquid hydrogen, liquid neon,liquid oxygen, liquefied fluorine, liquefied argon, liquefied methane,liquefied air, or the like. In some embodiments, the cryogen can includea cooled or cold gas such as, for example cooled or cold air. In someembodiments, the cryogen in the tank can be a mixture of liquid and gassuch as a liquid and gaseous cryogen, or in other words, can bepartially liquid. The cryogenic treatment system 100 can include a tank102, also referred to herein as a container 102, a cryogen source 102,or a canister 102. The tank 102 can comprise a variety of shapes andsizes and can be made from a variety of materials. In some embodiments,the tank 102 can comprise a metal cylinder defining an internal volumethat can contain the cryogen and/or they can contain pressurizedcryogen. In some embodiments, the metal cylinder can be made of aluminumor steel.

The tank 102 can, in some embodiments, include a heater 104, athermostat 106, and/or controller 108. The heater 104 can comprise anydesired heater capable of heating the tank 102 and/or the cryogencontained in the tank 102 to a desired temperature and/or until thecryogen contained in the tank 102 attains a desired pressure. Thedesired pressure can be, in some embodiments, less than 100 psi lessthan 500 psi less than 1,000 psi less than 2,000 psi less than 5,000 psibetween 0 and 2,000 psi between 500 and 1,500 psi approximately 1,000psi or any other or intermediate pressure. In some embodiments, theheater 104 can be located at or on a bottom 110 of the tank 102 and/orproximate to the bottom 110 of the tank 102. In some embodiments, thislocation of the heater 104 on and/or in the tank 102 can facilitateheating of the cryogen contained within the tank 102 and specificallythe heating of a liquid portion of the cryogen contained within thetank.

The thermostat 106 can comprise one or several features configured tomeasure the temperature within the tank 102. These can include, forexample, one or several thermocouples, thermistors, thermometers, or thelike. The thermostat 106 can be positioned at any desired location onthe tank 102 and can, in some embodiments, be positioned proximate tothe heater 104.

The controller 108 can be communicatively coupled with the heater 104and/or with the thermostat 106. In some embodiments, the controller 108can include one or several features that display one or severalattributes of the tank 102 and/or the cryogen such as, for example, thepressure in the tank 102, the amount of cryogen in the tank 102, thetemperature of the cryogen or the tank 102, or the like. The controller108 can further include one or several features whereby set pointinformation can be provided by the user to the controller and/or wherebyset points can be changed.

The controller 108 can, via the communicative coupling with the heater104 and/or with the thermostat 106 control the temperature of thecryogen and/or of the tank 102. In some embodiments, for example, thecontroller can receive one or several signals indicative of atemperature of the cryogen and/or of the tank 102 from the thermostat106. The controller can compare the signals to set point information andcan determine whether to increase or decrease the temperature of thecryogen and/or of the tank 102. Control the temperature of the cryogenand/or of the tank by, for example, controlling the powering of theheater 104 such as by, for example, controlling the amount of currentgoing to the heater 104. In some embodiments, the controller 108, theheater 104, and the thermostat 106 can sufficiently heat the tank 102 tomaintain a constant pressure and/or temperature during dispensing of thecryogen.

The tank 102 can include a switch 112 such as a safety switch. In someembodiments, the safety switch can be communicatively coupled with thecontroller 108 and/or the heater 104. In some embodiments, manipulationof the switch 112 can cut power to the heater 104 to prevent any furtherheating of the tank 102 and/or of the cryogen in the tank 102. In someembodiments, the switch 112 can be separate from the controller 108, andin some embodiments, the switch 112 can be integrated in the controller108.

The cryogenic treatment system 100 can include an applicator 114, alsoreferred to herein as a cryospray applicator 114, which applicator 114can include a nozzle 116, also referred to herein as a nozzle assembly116, that can include a linear array of orifices. In some embodiments,the cryospray applicator 114 can be a non-contact cryospray applicatorin that the nozzle 116 or other portion of the applicator 114 does notcontact the skin of the patient to cool the skin of the patient, butrather the cryogen is dispensed by the nozzle 116 to the skin of thepatient to cool the skin of the patient.

The applicator 114, and specifically the nozzle 116 can dispense cryogenfrom the tank 102 to the skin of the patient. In some embodiments, theapplicator 114 can be fluidly connected with the tank 102 via a tube118, also referred to herein as the hose 118, the supply tube 118, orconnecting tube 118. In some embodiments, the tube 118 can be fluidlyconnected with the internal volume of the tank via a port or apertureextending through the tank. In some embodiments, the tube 118 canconnect to the tank 102 at or proximate to the bottom 110 of the tank102. The connection of the tube 118 at or proximate to the bottom 110 ofthe tank 102 can facilitate the drawing of cryogen, and specifically thedrawing of liquid cryogen into the tube 118 and the delivering ofcryogen, and specifically the delivering of liquid cryogen to theapplicator 114 and the nozzle 116.

The tube 118 can comprise a variety of shapes and sizes and can be madefrom a variety of materials. In some embodiments, the tube can be madefrom a material that is able to withstand the temperature and/orpressure of the cryogen and/or to withstand the cryogen. In someembodiments, the tube 118 can have a diameter, a shape, and/or a linksuch that the pressure of the cryogen at the nozzle 116 and/or at theapplicator 114 is the same or substantially the same as at the tank 102.As used herein, substantially or approximately referred to a valuedeviating by less than 10%, 5%, 2%, or 1% from the value or values withwhich they are associated. Thus, the pressure of the cryogen at thenozzle 116 and/or at the applicator 114 is the same or substantially thesame as in the tank when the pressure of the cryogen at the nozzle 116and/or at the applicator 114 deviates by less than 10%, 5%, 2%, or 1%from the pressure of the cryogen in the tank 102.

FIG. 2 is a side-section view of one embodiment of the applicator 114including the nozzle 116. The applicator 114 can comprise a variety ofshapes and sizes and can be made from a variety of materials. In someembodiments, the applicator 114 can be a hand-held applicator 114, andin other embodiments, the applicator 114 can be part of an automatedsystem or device such as a robotic system or device, a teleoperatedsystem or device, or the like.

The applicator 114 can include a handle portion 200 and a head portion202. The handle portion 200 can include a grip 204 connected to the headportion 202. The grip 204 can be sized and shaped to be held in the handof an operator of the applicator 114. The head portion 202 can connectto the nozzle 116 and can specifically be coupled to an elongate member206, also referred to herein as a nozzle tube 206, of the nozzle 116 viaa nozzle base 208. In some embodiments, the nozzle base 208 can comprisea threaded plug such as, for example, a NPT threaded plug. The nozzlebase 208 can be made from a variety of materials including, for example,brass, steel, stainless steel, nickel, a nickel alloy, or the like.

As seen in FIG. 2, the tube 118 can extend along the grip 204 and cancouple to the head portion 202 at coupling 210. The coupling 210 caninclude, for example, a hose coupler 212 that can include, for example,a female hose coupling. The hose coupler 212 can threadingly engage witha head coupler 214, which head coupler 214 can be, for example, athreaded coupling. In some embodiments, and as depicted in FIG. 2, thehead coupler 214 threadingly engages features of the head portion 202 ofthe applicator 114 to couple the head coupler 214 to the head portion202.

The applicator 114 can include a filter 216. The filter 216 can comprisea variety of shapes and sizes and can be made from a variety ofmaterials. The filter 216 can be located in numerous positionsthroughout the applicator 114 and/or the tube 118. In some embodiments,the filter 216 can be located between the tube 118 and the nozzle 116,in the nozzle 116 such as in, for example, the nozzle base 208, in thecoupling 210 such as, for example, in the head coupler 214, or the like.

The filter 216 can be sized to eliminate and/or minimize clogs at thenozzle 116. In some embodiments, the filter 216 can be a 1μ filter, a10μ filter, a 25μ filter, a 50μ filter, 100μ filter, a between 10μ and100μ filter, a between 40μ and 50μ filter, an approximately 50μ filter,or any other desired filter. In some embodiments, the filter 216 cancomprise a ceramic filter, a polymer filter, a sintered metal filter, orany other desired filter type. In some embodiments, the filter 216 cancomprise a sintered stainless steel filter or mesh screen.

The head portion 202 of the applicator 114 can include a valve 218 thatcan control the flow of cryogen to the nozzle 116 and/or the dispensingof cryogen from the nozzle 116. The valve 218 can, in some embodiments,be controlled by a control feature 220 that can be, for example, abutton. In some embodiments, for example, manipulation of the controlfeature 220 can result in the opening or closing of the valve 218 andcan thus result in the initiation or the termination of dispensing ofcryogen. The head portion 202 of the applicator 114 can, in someembodiments, include a filler plug 222. In some embodiments, the fillerplug 222 can comprise a dead volume filler plug and can be located in asupply channel 224 of the head portion 202 proximate to the nozzle 116and specifically proximate to the nozzle base 208. In some embodiments,the supply channel 224 can extend through at least a portion of the headportion 202 of the applicator. In some embodiments, the valve 218interacts with the filler plug 222 to provide cryogen to the nozzle 116and/or to dispense cryogen from the nozzle 116.

As seen in the side-section, close-up view of FIG. 3 and in thefront-section, close-up view of FIG. 4, the elongate member 206 of thenozzle includes an internal volume 400 defined by walls 402 of theelongate member 206. A plurality of orifices 404, some or all of whichcan comprise a cylindrical aperture or cylindrical opening and thus canbe cylindrical orifices 404, extend through the walls 402 of theelongate member 206 to fluidly couple the internal volume 400 of theelongate member 206 to outside of the elongate member 206. Specifically,the orifices 404 extend from a proximal opening 406 contacting theinternal volume 400 of the elongate member 206 to distal openings 408.As seen FIG. 4, a channel 500 extending through the nozzle base 208fluidly connects with the internal volume 400 of the elongate member206. The channel 500 can further fluidly connect with the tube 118and/or with the valve 218 or the fill plug 222.

In some embodiments, the orifices 404 can each have the same, orapproximately the same diameter and/or depth, and in some embodiments,some or all of the orifices 404 can have different diameters and/ordepths. In some embodiments, the orifices 404 can be sized and shaped sothat the expansion of cryogen passing through the orifices 404 is anearly adiabatic expansion. In some embodiments, for example, eachorifice 404 can have a diameter of: approximately 0.001 inches,approximately 0.005 inches, approximately 0.007 inches, approximately0.008 inches, approximately 0.01 inches, approximately 0.02 inches,approximately 0.05 inches, approximately 0.08 inches, approximately 0.1inches, between approximately 0.001 and 0.01 inches, betweenapproximately 0.005 and 0.008 inches, or any other or intermediatediameter. In some embodiments, the orifices can have a depth ofapproximately 0.001 inches, approximately 0.005 inches, approximately0.008 inches, approximately 0.01 inches, approximately 0.02 inches,approximately 0.05 inches, approximately 0.08 inches, approximately 0.1inches, approximately 0.5 inches, between approximately 0.001 and 0.05inches, between approximately 0.005 and 0.02 inches, and/or any other orintermediate depth.

In some embodiments, and as seen in FIGS. 5 through 7, the plurality oforifices 404 can be arranged in a linear array 600 of orifices 404. Thisarray 600 of orifices 404 can include, for example, 3 orifices, 5orifices, 8 orifices, 10 orifices, 11 orifices, 15 orifices, 20orifices, 30 orifices, 50 orifices, 100 orifices, between 0 and 100orifices, between 0 and 50 orifices, between 0 and 25 orifices, between0 and 11 orifices, or any other or intermediate number of orifices. Insome embodiments, the linear array 600 can have a length ofapproximately 10 inches, approximately 5 inches, approximately 2 inches,approximately 1 inch, approximately 0.5 inches, between 0 and 10 inches,between 0 and 5 inches, between 0 and 2 inches, or any other orintermediate length. In some embodiments, each of the nozzles can beseparated by a distance of: approximately 1 inch, approximately 0.5inches, approximately 0.1 inches, approximately 0.05 inches,approximately 0.01 inches, between 0 and 1 inches, between 0 and 0.5inches, between 0 and 0.2 inches, or any other or intermediate distance.

In some embodiments, the plurality of orifices 404 forming the lineararray of orifices can be arranged in a single row of orifices as shownin FIG. 5, or in a plurality of rows 602-A, 602-B, 602-C of orifices404. In some embodiments, the linear array 600 can comprise one row oforifices, two rows of orifices, three rows of orifices, 5 rows oforifices, 7 rows of orifices, 10 rows of orifices, 20 rows of orifices,between 1 and 10 rows of orifices, or any other or intermediate numberof rows of orifices. In some embodiments, each of the rows 602-A, 602-B,602-C of orifices 404 can have the same number of orifices 404, and insome embodiments, some or all of the rows 602-A, 602-B, 602-C oforifices 404 can have a different number of orifices. In embodiments inwhich the linear array 600 comprises multiple rows of orifices 404, theorifices 404 in the different rows can be aligned as shown in FIG. 6, orthe orifices can be staggered as shown in FIG. 7. In some embodiments,the orifices 404 in the different rows of orifices 404 can have the samesize or dimensions, and in some embodiments, the orifices can havedifferent sizes or dimensions. In some embodiments, some or all of theorifices 404 in the linear array 600 can be equally and/or uniformlyspaced, and in some embodiments, some or all of the orifices 404 in thelinear array 600 can be unequally spaced and/or staggered.

In some embodiments, some or all of the plurality of orifices 404 candispense the cryogen, and in some embodiments, some or all of theplurality of orifices 404 can dispense a protective gas such as an inertgas. In some embodiments, this inert gas can have a desired watercontent such as, for example, less than 10% water by weight, less than5% water by weight, less than 1% water by weight, less than 0.1% waterby weight, less than 0.05% water by weight, less than 0.01% water byweight, less than 0.005% water by weight, less than 0.001% water byweight, or any other or intermediate value. This protective gas can forma protective curtain through which the cryogen can be dispensed toprevent the entrainment of ambient moisture in the cryogen. In someembodiments, for example, the entrainment of ambient moisture in thecryogen can adversely impact the temperature of the cryogen and/or theability to control the temperature of the skin or the cryogen at theskin. Entrained moisture can be detrimental to the operation of theapplicator 114 as entrained moisture can block one or several orifices404 and prevent proper dispensing of cryogen. Further, entrainedmoisture can result in the creation of a “snow” layer on the skin fromthe accumulation of ice crystals formed from the entrained moisture.This layer of ice can insulate the skin and can prevent the providing ofthe desired treatment to the skin.

The protective gas can be dispensed from the same orifices 404 fromwhich the cryogen is dispensed by delivering the protective gas beforethe delivery of the cryogen, or the protective gas can be delivered fromseparate orifices 404, such as curtain orifices 604, also referred toherein as curtain apertures 604 or curtain openings 604, than those fromwhich the cryogen is dispensed. As used herein, a curtain orifice 604refers to an orifice 404 through which the protective gas is delivered,and a cryogen orifice 606, also referred to herein as a cryogen aperture606 or a cryogen opening 606, refers to an orifice 404 through which acryogen is delivered. In some embodiments, a plurality of curtainorifices 604 can create an array of curtain orifices 604, and aplurality of cryogen orifices 606 can create an array of cryogenorifices 606.

In some embodiments, for example, one or more of the rows 602-A, 602-B,602-C of orifices 404 can be selected for delivery of cryogen and one ormore of the rows 602-A, 602-B, 602-C of orifices 404 can be selected fordelivery of the protective gas. In one embodiment, for example, one orseveral of the orifices 404 and/or one or several of the rows 602-A,602-B, 602-C of orifices 404 are selected for delivery of the protectivegas simultaneously or partially simultaneously with the delivery of thecryogen. In one such embodiment, for example, some or all of theorifices 404 in one or both of the rows 602-A and 602-C can be curtainorifices 603 configured for delivery of protective gas simultaneously orpartially simultaneously with the delivery of the cryogen from one orseveral cryogen orifices that can be located in the row 604-B. In someembodiments, curtain orifices 604 can be positioned to form a perimeteraround the cryogen orifices 606. In such an embodiment, the orifices 404in the rows 602-A and 602-C are curtain orifices 604 and additionally,the orifice 404 in row 602-B most proximate to a first end 806 of thenozzle tube 206 and the orifice 404 in row 602-B most proximate to asecond end 808 of the nozzle tube 206 are curtain orifices.

In some embodiments, some or all of the orifices 404 can deliver aheated gas. In some embodiments, for example, the cryogen and the heatedgas can be alternative delivered to cycle temperature of the skin of thepatient. In some embodiments, the heated gas can be delivered throughorifices 404 distinct from the orifices 404 through which cryogen isdelivered, and in some embodiments, the heated gas can be deliveredthrough the same orifices 404 through which cryogen is delivered.

The nozzle 116 can further include a shroud 700 that can shield one orseveral of the orifices 404. In some embodiments, for example, theshroud 700 can be sized and shaped to shield the plurality of orifices404 from contact with moist air and/or from the formation of icecrystals that could obstruct one or several of the orifices 404.Specifically, in some embodiments, the shroud 700 can create astagnation zone at the external and/or distal openings of the orifices.In some embodiments, the shroud 700 can comprise the same material asthe nozzle tube 206, and in some embodiments, the shroud 700 cancomprise a different material than the nozzle tube 706. In someembodiments, for example, the shroud can comprise a material having alower thermal conductivity than the material of the nozzle tube 706, orspecifically, in some embodiments, the nozzle tube 706 can comprise ametal such as, for example, a steel, stainless steel, nickel or a nickelalloy, aluminum, or brass, and the shroud 700 can comprise a polymer.

The shroud 700 can extend wholly or partially around the linear array600 of orifices 404. In some embodiments, the shroud comprises arectangular or ovular aperture 702 that extends around the linear array600 of orifices 404. The aperture 702 can have a width 704, a depth, anda length 706. In some embodiments, the shroud 700 can have a depth ofapproximately: 1× the diameter of the orifices 404, 2× the diameter ofthe orifices 404, 3× the diameter of the orifices 404, 5× the diameterof the orifices 404, 10× the diameter of the orifices 404, between 1×and 10× the diameter of the orifices 404, between 1× and 4× the diameterof the orifices 404, or any other or intermediate depth.

FIG. 8 is a schematic illustration of one embodiment of the applicationof cryogen to the skin of a patient. As seen, the cryospray applicator114 can be positioned at a location proximate to a portion of skin 300,also referred to herein as skin tissue 300, of the patient to betreated. The applicator 114 can be controlled to direct a planar spray302, also referred to herein as a linear curtain, of cryogen, which canbe or include liquid cryogen, or cold gas through the linear array 600of orifices 404 in the nozzle 116 of the applicator 114. In someembodiments, the planar spray comprises a cryogen mist such as a liquidcryogen mist, and in some embodiments, the liquid cryogen can compriseliquid carbon dioxide. This liquid cryogen or cold gas can cool an area304 of skin tissue 300 of the patient in a line of cooling treatment toeffect a treatment of the skin 300. In some embodiments, the planarspray 302 can have a temperature at the skin surface of between −4° C.and −80° C.

The applicator 114 can be moved as indicated by arrow 306 in thedirection indicated by arrow 306 which can result in the movement of thearea 304 as indicated by arrow 308 in the direction indicated by arrow308. This movement of the area 304 across the skin 300 of the patientcan create a treated area 310 that can be continuous when the applicator114 delivers a continuous planar spray 302 or interrupted when theapplicator 114 delivers a non-continuous planar spray 302 such as by,for example, intermittently delivering the planar spray 302.

In some embodiments, a mask 312 can be applied to and/or overlaid uponthe skin prior to delivery of the cryogen. This mask 312 can comprise anobject, item, or substance. In some embodiments, the mask 312 cancomprise a perforated member, a perforated film, a mesh, and/or atemperature controlled member. In some embodiments, for example, thetemperature of the mask 312 can be controlled to control a temperatureof all or portions of the skin, and specifically, in some embodiments,the mask 312 can be heated to heat the skin and/or to cyclically heatthe skin. In some embodiments, the mask 312 can affect the temperatureof the skin 300 by insulating and/or shielding the skin 300 from some ofthe cryogen applied to the skin 300 and/or to the mask 312 by theapplicator 114.

In some embodiments, the applicator 114 can further include a spacer,and specifically a mechanical spacer 800 as shown in FIGS. 9 and 10. Themechanical spacer 800 can be configured to engage with the skin of thepatient so as to maintain and/or at least maintain a desired, constant,and/or minimum spacing and/or distance between the nozzle 116 and/ororifices 404 or linear array 600 and the skin of the patient. Themechanical spacer 800 can be coupled to the head portion 202 and/or tothe nozzle 116. The mechanical spacer 800 can comprise a variety ofshapes, sizes, and designs. In some embodiments, the mechanical spacer800 can maintain a fixed spacing between the skin of the patient and thenozzle 116 and/or orifices 404 or linear array 600, and in someembodiments, the mechanical spacer 800 can be adjustable to change thedesired, constant, and/or minimum spacing and/or distance.

The mechanical spacer 800 can comprise a wheeled spacer 802. The wheeledspacer 800 can include one or several wheels 804 including, for example,1, 2, 3, 4, 6, 8, 10, or any other or intermediate number of wheels 804.In the embodiment of FIG. 8, the wheeled spacer 802 includes a firstwheel 804-A and a second wheel 8004-B. The first wheel 804-A is locatedproximate to the first end 806 of the nozzle tube 206 and/or of thelinear array 600, and the second wheel 804-B is located proximate to thesecond end 808 of the nozzle tube 206 and/or of the linear array 600.

The mechanical spacer 800 can comprise a slider spacer 900. The sliderspacer 900 can include a plurality of legs 902 or prongs 902 including,for example, 1, 2, 3, 4, 6, 8, 10, or any other or intermediate numberof legs 902. In some embodiments, the legs 902 can be adjustable withrespect to the nozzle 116 and/or the linear array 600 of orifices 404 tochange the distance between the nozzle 116 and/or the linear array 600of orifices 404 and the patient's skin.

With reference now to FIG. 11, a flowchart illustrating one embodimentof a process 1000 for cooling skin of a patient and/or for applying thecryogen is shown. In some embodiments, the skin can be cooled and/or thecryogen can be applied as part of a cryogenic treatment. In someembodiments, this treatment can alter a pigmentation appearance and/orpigmentation of the treated skin, and in some embodiments, thistreatment can alter a texture, tension, tone, smoothness, or tightnessof the treated skin. In some embodiments, this cryogenic treatment canbe to treat one or several indications that can affect large areas ofskin such as, for example: pigmentation or coloration relatedindications including hypopigmentation or hyperpigmentation; acne;rosacea; psoriasis or the like. In some embodiments, this cryogenictreatment can be to treat blemishes including pigmentation relatedblemishes. Such blemishes may include: melasma; lentigo; freckle;birthmark, liver spot, age spot, or café au lait macule.

The process can be performed with all or portions of the cryogenictreatment system 100. The process 1000 begins at block 1002, wherein themask 312 is applied to the skin and/or placed on the skin. After themask is applied to the skin, the cryogen supply 102 is heated asindicated by block 1004 of process 1000. In some embodiments, the maskcan be applied to the skin prior to directing the planar spray from thelinear array 600 of orifices 404. The cryogen supply 102 can containcryogen that can be, for example, in both a liquid and a gaseous form.In some embodiments, the tank 102 can be heated by the heater 104 ascontrolled by the controller 108 according to information received fromthe thermostat 106. In some embodiments, the tank 102 can be heated to adesired temperature and/or until a desired pressure inside the tank 102is reached. The tank 102 can be heated, in some embodiments, such thatthe tank 102 maintains the desired pressure.

After the tank is heated, the cryogen, and specifically liquid cryogenis transported from the cryogen supply 102 to the applicator 114 via thesupply tube 118 as indicated in block 1006 of process 1000. In someembodiments, the cryogen can be transported through the tube 118 via apressure differential that can arise, for example, from the opening ofthe valve 218. In some embodiments, the pressure of the liquid cryogenin the tube 118 can be equal and/or approximately equal to the pressureof the liquid cryogen in the tank 102.

At block 1008 of process 1000, the applicator 114 is positionedproximate to the skin of the patient. In some embodiments, positioningthe cryospray applicator 114 proximate to the skin of the patient, andparticularly to the area of the skin tissue of the patient to be treatedcan include positioning a non-contact cryospray applicator 114 proximateto the area of the skin tissue of the patient, or positioning acryospray applicator 114 including a mechanical spacer 800 proximate tothe area of the skin tissue of the patient. In some embodiments, thiscan include positioning the applicator a desired distance from the skinof the patient, which can include, for example, adjusting the mechanicalspacer 800 so that the applicator 114 is maintained at the desireddistance from the skin of the patient by the mechanical spacer 800. Themechanical spacer 800 can, in some embodiments, comprise the wheeledspacer 802 and/or the sliding spacer 900. In some embodiments, and aspart of positioning the applicator 114, the skin of the patient can becontacted with the mechanical spacer 800. In some embodiments, themechanical spacer can maintain the predetermined distance between theapplicator 114 and the skin. In some embodiments, this predetermineddistance can be, for example, between 1 inch and 3 inches, and/orbetween 0.125 inches and 3 inches.

At block 1010, the protective gas is delivered to form a protectivecurtain. In some embodiments, the creation of a protective curtain caninclude the dispensing of protective gas that can include an inert gasand/or a dry gas. In some embodiments, the protective gas can bedelivered before, during, and/or after delivery of the cryogen. Theprotective gas can be delivered from the same orifices 404 from whichthe cryogen is delivered, or from different orifices 404, such as one orseveral curtain orifices 604, than the orifices 404 from which thecryogen is delivered. In some embodiments, this protective curtain canprevent water entrainment or ambient air entrainment as the cryogen,which can include: a liquid cryogen; a gaseous cryogen; a two-phasefluid; cooled air; and/or carbon dioxide and/or cold gas movesdownstream of the orifices 404 as delivery of the cryogen from theorifices 404.

At block 1012, the cryogen is dispensed, delivered, and/or expelled fromthe applicator 114, and specifically, a planar spray 302 of cryogen orcold gas is directed through the linear array 600 of orifices 404 of thecryospray applicator 114. In some embodiments, this can include thecontrol of the applicator 114 to dispense and/or expel the cryogen. Insome embodiments this can include, for example, the manipulation of thecontrol feature 220 to cause the dispensing and/or expelling of thecryogen from the applicator 114. In some embodiments, the cryogen can bedispensed and/or expelled from the nozzle 206, and particularly from thelinear array of orifices 600 to form a linear curtain of cryogendownstream from the nozzle 206.

In some embodiments, directing the planar spray of cryogen or cold gasthrough the linear array of orifices can include locally freezing anepidermis. This local freezing of the epidermis can alter a pigmentationof the area of the skin tissue of the patient. In some embodiments,directing the planar spray of cryogen or cold gas through the lineararray of orifices can include locally disrupting an epidermis. Thislocal disruption of the epidermis can result in the gradual skinlightening in the area of the skin tissue of the patient.

In some embodiments, the step of block 1012 can include transportingcryogen from the cryogen supply 102 to the applicator 114 via the supplytube 118, and in other embodiments, this can be a separate step asindicated in FIG. 11. In some embodiments, a pressure of the cryogen atthe supply tube 118 can be substantially equal to the desired pressurein the cryogen supply 102.

At block 1014, the cryospray applicator 114 can be moved with respect tothe skin as indicated, for example, in FIG. 8. In some embodiments, themovement of the applicator 114 can provide a linear curtain of coolingtreatment to the skin, and specifically to the area 304 of skin tissue300 of the patient. In some embodiments, the applicator 114 can be movedby hand, and in other embodiments, the applicator 114 can be moved by amachine.

After the cryospray applicator 114 has been moved, the process 1000 canproceed to block 1016, wherein all or portions of the skin are warmed.In some embodiments, this warming can be performed via the mask 312, andin some embodiments, this warming can be performed via the applicator114. In one embodiment, for example, a warm gas, cryogen, and/or air canbe dispensed by the nozzle 116 to the skin to warm the skin, andspecifically to convectively warm the skin. In some embodiments, thewarm gas, cryogen, and/or air can be dispensed by the same or differentorifices 404 as dispense the protective gas and/or the cryogen.

In some embodiments some or all of the steps of process 1000 can berepeated in the course of a single treatment. In some embodiments, forexample, some or all of the steps of blocks 1010 through 1016 can berepeated one or several times as part of a treatment. This can include,for example, the repeated directing of the planar spray and/or thedelivering of the cryogen or cold gas, the moving of the applicator, andthe warming of the skin. In some embodiments, this cyclical warming andcooling of the skin may provide treatment benefits and this cycle can beperformed to maximize these treatment benefits and/or to achieve adesired treatment benefit.

The subject matter of the present invention is described here withspecificity, but the claimed subject matter may be embodied in otherways, may include different elements or steps, and may be used inconjunction with other existing or future technologies.

This description should not be interpreted as implying any particularorder or arrangement among or between various steps or elements exceptwhen the order of individual steps or arrangement of elements isexplicitly described. Different arrangements of the components depictedin the drawings or described above, as well as components and steps notshown or described are possible. Similarly, some features andsub-combinations are useful and may be employed without reference toother features and sub-combinations. Embodiments of the invention havebeen described for illustrative and not restrictive purposes, andalternative embodiments will become apparent to readers of this patent.Accordingly, the present invention is not limited to the embodimentsdescribed above or depicted in the drawings, and various embodiments andmodifications may be made without departing from the scope of the claimsbelow.

What is claimed is:
 1. A method of cooling an area of skin tissue of apatient, the method comprising: positioning a cryospray applicator to aposition proximate to the area of skin tissue of the patient to betreated; directing a planar spray of cryogen through a linear array oforifices of the cryospray applicator to cool the area of skin tissue ofthe patient in a line of cooling treatment to effect a treatment of thearea of skin tissue; and moving the cryospray applicator non-parallel tothe line of cooling treatment while directing the planar spray ofcryogen to provide a moving linear curtain of cooling treatment to coolthe area of skin tissue of the patient and create a continuous treatedarea.
 2. The method of claim 1, further comprising: detecting anattribute of cryogen within a tank; and controlling a heater to heat thetank containing cryogen with a tank heater such that the tank maintainsa desired pressure.
 3. The method of claim 2, wherein directing theplanar spray of cryogen through the linear array of orifices comprisestransporting liquid cryogen from the tank to the cryospray applicatorvia a supply tube, wherein a pressure of the liquid cryogen in thesupply tube is substantially equal to a desired pressure in the tank. 4.The method of claim 3, wherein directing the planar spray of cryogenthrough the linear array of orifices comprises transporting liquidcryogen through the cryospray applicator to an internal volume of anozzle tube.
 5. The method of claim 4, wherein nozzle tube comprisescentrally located nozzle base defining a channel fluidly connecting thesupply tube to the internal volume of the nozzle tube, and wherein thenozzle tube comprises an elongate member defining the orifices in thelinear array of orifices, the orifices extending into the internalvolume of the nozzle tube.
 6. The method of claim 5, wherein a shroudextends around the orifices, and wherein the shroud creates a stagnationzone surrounding the orifices during directing of the planar spray ofcryogen through the linear array of orifices of the cryosprayapplicator.
 7. The method of claim 1, wherein the cryogen comprises: aliquid cryogen; a gaseous cryogen; a two-phase fluid; cooled air; orcarbon dioxide.
 8. The method of claim 7, wherein the liquid cryogencomprises liquid carbon dioxide.
 9. The method of claim 1, wherein thecryogen comprises a plurality of droplets.
 10. The method of claim 1,wherein the planar spray of cryogen has a temperature at a surface ofthe area of skin tissue of between −4 C to −80 C.
 11. The method ofclaim 1, wherein each orifice comprises a cylindrical opening.
 12. Themethod of claim 1, wherein the linear array of orifices comprises asingle row of orifices or a plurality of rows of orifices.
 13. Themethod of claim 1, further comprising delivering a gas to form aprotective curtain through which the cryogen moves downstream of theorifices.
 14. The method of claim 13, wherein the protective curtainprevents water entrainment or ambient air entrainment as the cryogenmoves downstream of the orifices.
 15. The method of claim 13, whereinthe gas is expelled from the orifices before or during the directing theplanar spray of cryogen from the orifices.
 16. The method of claim 13,wherein the gas comprises at least one of: a dry gas; and an inert gas.17. The method of claim 1, further comprising applying a mask to thearea of skin tissue of the patient prior to directing the planar sprayof cryogen from the linear array of orifices.
 18. The method of claim17, wherein the mask comprises a perforated film.
 19. The method ofclaim 1, wherein positioning the cryospray applicator to the positionproximate to the area of skin tissue of the patient to be treatedcomprises contacting the area of skin tissue of the patient with amechanical spacer to maintain a predetermined distance between thecryospray applicator and the area of skin tissue.
 20. The method ofclaim 19, wherein the predetermined distance comprises a range from0.125 inches to 3 inches.
 21. The method of claim 19, wherein themechanical spacer comprises at least one of: a wheeled spacer; and asliding spacer.
 22. The method of claim 1, wherein positioning thecryospray applicator to the position proximate to the area of skintissue of the patient to be treated comprises positioning a non-contactcryospray applicator proximate to the area of skin tissue of thepatient.
 23. The method of claim 1, further comprising warming the areaof skin tissue of the patient after the cooling treatment.
 24. Themethod of claim 23, wherein the area of skin tissue of the patient iswarmed by delivery of warm air or cryogen from the same or differentorifices for convective warming.